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5. Modelling COVID-19 vaccination status and adherence to public health and social measures, Eastern Mediterranean Region and Algeria/Modelisation du statut de vaccination contre la COVID-19 et de l'adhesion aux mesures sociales et de sante publique, Region de la Mediterranee orientale et Algerie/Modelizacion del estado de vacunacion contra la COVID-19 y del cumplimiento de las medidas sociales y de salud publica, Region del Mediterraneo Oriental y Argelia

Author

Nikoloski, Zlatko, Bain, Robert, Elzalabany, Manal K., Hanna, Peggy, Aynsley, Tara Rose, Samhouri, Dalia, Menchini, Leonardo, Kapil, Neha, and Gillespie, Amaya

Subjects
Medical research -- Models -- Analysis -- Surveys, Medicine, Experimental -- Models -- Analysis -- Surveys, Vaccination -- Models -- Research -- Analysis -- Surveys, Cellular telephones -- Surveys -- Research -- Models -- Analysis, Public health -- Analysis -- Research -- Models -- Surveys, Coronaviruses -- Surveys -- Analysis -- Models -- Research, Wireless telephone, Wireless voice/data device, Health
Abstract

Objective To study the link between coronavirus disease 2019 (COVID-19) vaccination status and adherence to public health and soda measures in Members of the Eastern Mediterranean Region and Algeria. Methods We analysed two rounds of a large, cross-country, repeated cross-sectional mobile phone survey in June-July 2021 an October-November 2021. The rounds included 14 287 and 14 131 respondents, respectively, from 23 countries and territories. Question covered knowledge, attitudes and practices around COVID-19, and demographic, employment, health and vaccination status. We use logit modelling to analyse the link between self-reported vaccination status and individuals' practice of mask wearing, physical distancing and handwashing. We used propensity score matching as a robustness check. Findings Overall, vaccinated respondents (8766 respondents in round 2) were significantly more likely to adhere to preventive measures that those who were unvaccinated (5297 respondents in round 2). Odds ratios were 1.5 (95% confidence interval, CI: 1.3-1.8) for mask wearing 1.5 (95% CI: 1.3-1.7) for physical distancing; and 1.2 (95% CI: 1.0-1.4) for handwashing. Similar results were found on analysing subsample of low- and middle-income countries. However, in high-income countries, where vaccination coverage is high, there was no significant link between vaccination and preventive practices. The association between vaccination status and adherence to public health advice was sustained over time, even though self-reported vaccination coverage tripled over 5 months (19.4% to 62.3%; weighted percentages). Conclusion Individuals vaccinated against COVID-19 maintained their adherence to preventive health measures. Nevertheless, reinforcement of public health messages is important for the public's continued compliance with preventive measures. Objectif Etudier le lien entre le statut de vaccination contre la maladie a coronavirus 2019 (COVID-19) et l'adhesion aux mesures sociales et de sante publique en Algerie et au sein des Membres de la Region de la Mediterranee orientale. Methodes Nous avons analyse deux series de resultats issus d'une vaste enquete transnationale et transversale realisee a intervalles reguliers via telephone mobile en juin-juillet 2021 et octobre-novembre 2021. Ces series ont comptabilise respectivement 14 287 et 14 131 participants repartis sur 23 pays et territoires. Les questions portaient sur les connaissances, attitudes et pratiques relatives a la COVID-19, ainsi que sur le statut demographique, professionnel, sanitaire et vaccinal. Nous avons utilise un modele Logit pour examiner le lien entre le statut vaccinal rapporte et les pratiques de chacun en matiere de port du masque, de distanciation physique et de lavage des mains. Enfin, nous avons procede a un appariement des coefficients de propension en guise de test de robustesse. Resultats Globalement, les repondants vaccines (8766 dans la deuxieme serie) etaient nettement plus enclins a respecter les mesures de prevention que les repondants non vaccines (5297 dans la deuxieme serie). Lodds ratio s'elevait a 1,5 (intervalle de confiance de 95%, IC: 13-1,8) pour le port du masque; 1,5 (IC de 95%: 1,3-1,7) pour la distanciation physique; et 1,2 (IC de 95%: 1,0-1,4) pour le lavage des mains. Des resultats similaires ont ete obtenus lors de l'analyse des sous-echantillons provenant de pays a revenu faible et intermediaire. Cependant, dans les pays a revenu eleve oU la couverture vaccinale est importante, aucune correlation n'a ete etablie entre la vaccination et les pratiques preventives. Le lien entre le statut vaccinal et l'adhesion aux mesures de sante publique s'est maintenu au fil du temps, meme si la couverture vaccinale a triple en cinq mois (passant de 19,4% a 62,3%; pourcentages ponderes). Conclusion Les personnes vaccinees contre la COVID-19 ont continue a respecter les mesures preventives en matiere de sante. Il faut toutefois renforcer les messages de sante publique afin que la population ne renonce pas a appliquer ces mesures. Objetivo Analizar la relacion entre el estado de vacunacion contra la enfermedad por coronavirus de 2019 (COVID-19) y el cumplimiento de las medidas sociales y de salud publica en los Estados Miembros de la Region del Mediterraneo Oriental y Argelia. Metodos Se analizaron dos rondas de una gran encuesta transversal de telefonia movil repetida entre paises realizada en junio y julio de 2021 y en octubre y noviembre de 2021. Las rondas incluyeron 14 287 y 14 131 encuestados, respectivamente, de 23 paises y territorios. Las preguntas incluian conocimientos, actitudes y practicas en relacion con la COVID-19, asi como la situacion demografica, laboral, sanitaria y de vacunacion. Se utilizo un modelo logit para analizar la relacion entre el estado de vacunacion informado por los encuestados y la practica del uso de mascarillas, el distanciamiento fisico y el lavado de manos. Se utilizo el emparejamiento por puntuacion de propension como comprobacion de consistencia. Resultados En general, los encuestados vacunados (8766 encuestados en la ronda 2) eran significativamente mas propensos a cumplir las medidas preventivas que los no vacunados (5297 encuestados en la ronda 2). Las razones de posibilidades fueron de 1,5 (intervalo de confianza del 95%, IC: 1,3-1,8) para el uso de mascarilla; 1,5 (IC del 95%: 13-1,7) para el distanciamiento fisico; y 1,2 (IC del 95%: 1,0-1,4) para el lavado de manos. Se encontraron resultados similares al analizar submuestras de paises de ingresos bajos y medios. Sin embargo, en los paises de ingresos altos, donde la cobertura de vacunacion es alta, no hubo una relacion significativa entre la vacunacion y las practicas preventivas. La asociacion entre el estado de vacunacion y el cumplimiento de las recomendaciones de salud publica se mantuvo en el tiempo, a pesar de que la cobertura de vacunacion informada por las personas se triplico en 5 meses (del 19,4% al 62,3%; porcentajes ponderados). Conclusion Las personas vacunadas contra la COVID-19 mantuvieron su adhesion a las medidas sanitarias preventivas. No obstante, el refuerzo de los mensajes de salud publica es importante para que la poblacion siga cumpliendo las medidas preventivas., Introduction The introduction of vaccines for coronavirus disease 2019 (COVID-19) added another measure to the existing set of recommended preventive measures (wearing a mask in public, keeping a distance from [...]

Published
2023
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25. Evaluation of progress toward universal health coverage in Myanmar: A national and subnational analysis

Author

Nikoloski, Zlatko, McGuire, Alistair, and Mossialos, Elias

Subjects
Myanmar -- Health policy, Socialized medicine -- Quality management, National health insurance -- Evaluation, Poor -- Health aspects, Company business management, Biological sciences
Abstract

Background Universal health coverage (UHC) encompasses 2 main components: access to essential healthcare services and protection from financial hardship when using healthcare. This study examines Myanmar's efforts to achieve UHC on a national and subnational level. It is a primer of studying the concept of UHC on a subnational level, and it also establishes a baseline for assessing future progress toward reaching UHC in Myanmar. Methods and findings The study uses the Demographic and Health Survey (2015) and the Myanmar Living Conditions Survey (MLCS; 2017) and adapts a previously developed UHC index to provide insights into the main barriers preventing the country's progress toward UHC. We find a negative correlation between the UHC index and the state/region poverty levels. The equity of access analysis reveals significant pro-rich inequity in access to all essential healthcare services. Socioeconomic status and limited availability of healthcare infrastructure are the main driving forces behind the unequal access to interventions that are crucial to achieving UHC by 2030. Finally, financial risk protection analysis shows that the poor are less likely to use healthcare services, and, once they do, they are at a greater risk of suffering financial catastrophe. Limitations of this study revolve around its correlational, rather than causal, nature. Conclusions We suggest a 2-pronged approach to help Myanmar achieve UHC: Government and state authorities should reduce the financial burden of seeking healthcare, and, coupled with this, significant investment in and expansion of health infrastructure and the health workforce should be made, particularly in the poorer and more remote states., Author(s): Zlatko Nikoloski *, Alistair McGuire, Elias Mossialos Introduction Universal health coverage (UHC) encompasses 2 main components: access to essential healthcare services and protection from financial hardship when using healthcare [...]

Published
2021
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31. Corruption, inequality and population perception of healthcare quality in Europe

Author

Nikoloski, Zlatko, Mossialos, Elias, Nikoloski, Zlatko, and Mossialos, Elias

Abstract

Background: Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population’s perception of health care quality and patient safety in a cross-country setting. Methods: We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. Results: We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients’ perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Conclusions: Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging.

Published
2022

37. Determinants of diabetes in Kuwait: evidence from the World Health Survey

Author

Nikoloski, Zlatko

Subjects
RA0421 Public health. Hygiene. Preventive Medicine, HV Social pathology. Social and public welfare. Criminology
Abstract

Diabetes is one of the most prevalent non-communicable diseases in the Middle East and North Africa (MENA) region, particularly among countries within the Gulf Cooperation Council (GCC). We analysed data from the World Health Organization’s World Health Survey conducted in Kuwait in 2013 in order to distil the main demographic and socio-economic determinants of diabetes. A subjective measure of diabetes was used given the low blood chemistry measurement response rates. An analysis of key risk factors indicated that obese, hypertensive and insufficiently active respondents were more likely to be diabetic. In addition, when examining the prevalence of multiple chronic conditions, our results showed that diabetic patients were more likely to have been diagnosed with two or more chronic conditions compared to non-diabetics. Finally, results from the multivariate logistic regression model indicated that people’s weight, age and employment status were the most significant predictors of diabetes. Although not the focus of this paper, similar results yield for the entire population (i.e. nationals and expatriates). Given the cost associated with diabetes and that diabetics were more likely to suffer from multiple chronic conditions, the government should devote more effort to preventive types of healthcare.

Published
2020

43. Mortality and Financial Crises

Author

Gerry, Christopher J., Mickiewicz, Tomasz M., and Nikoloski, Zlatko

Abstract

Drawing on a dataset covering more than 100 countries from 1970 to 2007, we estimate the impact of different types of financial crises on male and female mortality. We find that only currency crises have a direct short‐term impact on mortality rates. We stylize our reading of the key empirical evidence of this paper in the following way: of three distinct types of financial crises, it is currency crises that have a direct short‐term impact on mortality rates, and this is particularly the case for males.

Published
2019

50. Estimating the size of external effects of energy subsidies in transport and agriculture

Author

Commander,Simon John, Nikoloski,Zlatko Slobodan, and Vagliasindi,Maria

Subjects
Transport and Environment,Energy Production and Transportation,Transport Economics Policy&Planning,Climate Change Economics,Climate Change Mitigation and Green House Gases
Abstract

It is widely accepted that the costs of underpricing energy are large, whether in advanced or developing countries. This paper explores how large these costs can be by focussing on the size of the external effects that energy subsidies in particular generate in two important sectors?transport and agriculture?in two countries in the Middle East and North Africa, the Arab Republic of Egypt (transport) and the Republic of Yemen (agriculture). The focus is mainly on the costs associated with congestion and pollution, as well as the impact of underpriced energy for depletion of scarce water resources, including through crop selection. Quantifying the size of external effects in developing countries has received relatively little analytical attention, although there is a significant body of literature for developed countries. By building on earlier research, as well as employing the United Nations ForFITS model, the paper provides indicative estimates of the external costs of energy subsidies, as manifested in congestion and pollution. The estimates using simulations indicate that these costs could be materially reduced by elimination or reduction of energy subsidies. The paper also describes the impact of energy subsidies on water consumption in a region where water resources are particularly limited. The findings provide further evidence of the adverse and significant consequences of subsidizing energy.

Published
2015

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